LITTLE ROCK VAMC (NPI# 1063450617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063450617 |
| Entity Type | Organization |
| Organization Name | LITTLE ROCK VAMC |
| Other Organization Name | MOUNTAIN HOME VA CLINIC |
| Practice Address |
759 Highway 62 E Suite 331 Mountain Home AR 72653-3260 |
| Mailing Address |
Po Box 94499 Cleveland OH 44101 |
| Practice Telephone | 6153553451 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-09-26 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Mountain Home VA Clinic | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073821518 | Little Rock Vamc | Clinic/Center | 1520 E Dave Ward Dr, Conway, AR 72032-9649 | 2010-09-17 |
| 1861439697 | Little Rock Vamc | Clinic/Center | 300 Morrow St S, Mena, AR 71953 | 2006-06-01 |
| 1215982582 | Little Rock Vamc | Clinic/Center | 177 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2006-05-24 |
| 1215980164 | Little Rock Vamc | Clinic/Center | 1702 N West Ave, El Dorado, AR 71730 | 2006-05-19 |
| 1295120152 | Little Rock Vamc | Clinic/Center | 4300 W 7th St, Little Rock, AR 72205-5446 | 2015-03-30 |
| 1528456894 | Little Rock Vamc | Clinic/Center | 1000 Main St, Little Rock, AR 72202-3820 | 2015-01-08 |
| 1518275056 | Little Rock Vamc | Clinic/Center | 3106 W 2nd Ct, Russellville, AR 72801-4503 | 2010-09-17 |
| 1063745891 | Little Rock Vamc | Clinic/Center | 1120 S Main St, Searcy, AR 72143-7319 | 2009-09-11 |
| 1548457146 | Little Rock Vamc | Clinic/Center | 4747 Dusty Lake Dr, Pine Bluff, AR 71603-8742 | 2007-09-27 |
| 1619926268 | Little Rock Vamc | General Acute Care Hospital | 4300 W 7th St, Little Rock, AR 72205-5446 | 2006-05-10 |
| Street Address |
759 HIGHWAY 62 E SUITE 331 |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-3260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053477091 | Cynthia Ann Hutchison | Pharmacist | 759 Highway 62 E, Suite 331, Mountain Home, AR 72653-3260 | 2006-12-27 |
| 1669413142 | Thomas Craig Burns | Social Worker | 759 Highway 62 E, Mountain Home, AR 72653-3209 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003223165 | Boise Vamc | Clinic/Center | 815 N 6th E, Mountain Home, ID 83647-2207 | 2014-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1073821518 | Little Rock Vamc | Clinic/Center | 1520 E Dave Ward Dr, Conway, AR 72032-9649 | 2010-09-17 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1649401316 | Memphis Vamc | Clinic/Center | 125 Quarles Ln, West Helena, AR 72390-1923 | 2009-07-29 |
| 1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
| 1417996489 | Shreveport Vamc | Clinic/Center | 910 Realtor Road, Texarkana, AR 71854-1020 | 2006-06-05 |
| 1861439697 | Little Rock Vamc | Clinic/Center | 300 Morrow St S, Mena, AR 71953 | 2006-06-01 |
| 1619923398 | Memphis Vamc | Clinic/Center | 2908 S Caraway Rd Ste B, Jonesboro, AR 72401-7306 | 2006-05-25 |
| 1215982582 | Little Rock Vamc | Clinic/Center | 177 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2006-05-24 |
| 1215980164 | Little Rock Vamc | Clinic/Center | 1702 N West Ave, El Dorado, AR 71730 | 2006-05-19 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
Please comment or provide details below to improve the information on LITTLE ROCK VAMC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.